Question

A 22-year-old woman presents with symmetric lower extremity weakness. She recently had a diarrheal illness. Which of the following might you expect on further work-up?

a) Creatine kinase elevation
b) Elevated protein of the cerebrospinal fluid
c) Hyperreflexia
d) Meningeal enhancement on MRI of the brain

Answer 1

a) Creatine kinase elevationBased on the symptoms and history provided, elevated protein of the cerebrospinal fluid would be expected on further work-up for the 22-year-old woman with symmetric lower extremity weakness following a diarrheal illness, suggesting Guillain-Barré syndrome.

Step-by-step explanation:

A 22-year-old woman presents with symmetric lower extremity weakness after a diarrheal illness. In this scenario, one might expect to find on further work-up elevated protein of the cerebrospinal fluid (CSF). This is because recent gastrointestinal infection followed by weakness may suggest a diagnosis of Guillain-Barré syndrome (GBS), which is often associated with elevated protein levels in the CSF without a proportional increase in white blood cells, a condition known as albuminocytologic dissociation.

Option (a) Creatine kinase elevation is more typically associated with muscular diseases. Option (c) Hyperreflexia would be less likely in GBS, as it typically presents with areflexia or hyporeflexia. Option (d) Meningeal enhancement on MRI of the brain may be seen in cases of meningitis but is not typically associated with GBS.